Serotonin-norepinephrine Reuptake Inhibitors and Acute Kidney Injury
Overview
- Phase
- Not Applicable
- Intervention
- Duloxetine
- Conditions
- Depression
- Sponsor
- Canadian Network for Observational Drug Effect Studies, CNODES
- Enrollment
- 3255526
- Locations
- 1
- Primary Endpoint
- Acute Kidney Injury (AKI)
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
The purpose of this study is to determine if there is an excess risk of acute kidney injury (AKI) with Serotonin-norepinephrine reuptake inhibitors (SNRIs) as compared to Selective serotonin reuptake inhibitors (SSRIs), two classes of medication used for the treatment of depression.
Detailed Description
We plan to conduct retrospective population-based cohort studies within eight administrative databases from Canada, the United States, and the United Kingdom. Within each cohort, a nested case-control analysis will be performed to estimate incidence rate ratios (RR) of AKI associated with SNRIs compared to SSRIs using conditional logistic regression, with adjustment for high-dimensional propensity scores at baseline. The overall effect across sites will then be estimated using meta-analytic methods.
Investigators
Eligibility Criteria
Inclusion Criteria
- •A first prescription of an antidepressant of the SNRI or SSRI class of any dose between January 1, 1997 and March 31, 2010.
Exclusion Criteria
- •They were \<12 years old at the time of cohort entry.
- •They had less than 1 year of information in the database prior to the date of cohort entry.
- •They had a prescription of an SNRI or SSRI in the year before the date of cohort entry.
- •They had a prescription for both an SNRI and an SSRI on the day of cohort entry.
- •They had a history of chronic kidney disease (including kidney transplantation and dialysis) or AKI in the year preceding cohort entry.
- •The subject was previously included in the cohort.
Arms & Interventions
SNRI Exposure Group
Patients who received a new prescription for an SNRI (duloxetine, venlafaxine, or desvenlafaxine at any dosage) with no prescriptions for either SNRI or SSRI in the prior year.
Intervention: Duloxetine
SNRI Exposure Group
Patients who received a new prescription for an SNRI (duloxetine, venlafaxine, or desvenlafaxine at any dosage) with no prescriptions for either SNRI or SSRI in the prior year.
Intervention: Venlafaxine
SNRI Exposure Group
Patients who received a new prescription for an SNRI (duloxetine, venlafaxine, or desvenlafaxine at any dosage) with no prescriptions for either SNRI or SSRI in the prior year.
Intervention: Desvenlafaxine
SSRI Exposure Group
Patients who received a new prescription for an SSRI (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline at any dosage) with no prescriptions for either SSRI or SNRI in the prior year.
Intervention: Citalopram
SSRI Exposure Group
Patients who received a new prescription for an SSRI (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline at any dosage) with no prescriptions for either SSRI or SNRI in the prior year.
Intervention: Escitalopram
SSRI Exposure Group
Patients who received a new prescription for an SSRI (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline at any dosage) with no prescriptions for either SSRI or SNRI in the prior year.
Intervention: Fluoxetine
SSRI Exposure Group
Patients who received a new prescription for an SSRI (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline at any dosage) with no prescriptions for either SSRI or SNRI in the prior year.
Intervention: Fluvoxamine
SSRI Exposure Group
Patients who received a new prescription for an SSRI (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline at any dosage) with no prescriptions for either SSRI or SNRI in the prior year.
Intervention: Paroxetine
SSRI Exposure Group
Patients who received a new prescription for an SSRI (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline at any dosage) with no prescriptions for either SSRI or SNRI in the prior year.
Intervention: Sertraline
Outcomes
Primary Outcomes
Acute Kidney Injury (AKI)
Time Frame: 2 years
AKI will be defined as patients hospitalized with one of the following diagnosis codes for AKI in any of the listed diagnoses: ICD-9-CM codes 584, 584.5, 584.6, 584.7, 584.8, or 584.9; ICD-10 N17, N17.0, N17.1, N17.2, N17.8, or N17.9.